This entry includes 1) a two-part series on Medicare Advantage, 2) a story about reducing excessive ER visits by Medicaid patients, and 3) a historic look back at the genesis of Hartford’s first hospital. 1. The two-part Medicare Advantage series is a deep dive into an issue I started reporting in October 2013 after UnitedHealthcare, the nation’s largest health insurer, decided to drop thousands of medical doctors from its Medicare Advantage network. The news became public only days before open enrollment began, and there were few details about which doctors were being cut and why. I tracked the issue from the early complaints by two Connecticut medical societies through a federal court battle and finally, a change in policy by the Centers for Medicare and Medicaid Services. The insurance company stonewalled us for most of the process. I worked around that lack of information by getting letters sent to patients and correspondence with physicians and medical societies. I analyzed the funding of Medicare Advantage to explain that insurers get more money per Medicare recipient, which puts taxpayers on the hook for a service that leaves many patients still unhappy and unable to be treated by the doctors they have seen for years. More to the point, there was no safeguard against an insurance company dropping hospitals and doctors from its network. Now there is. The CMS change was reported widely by various news sources, but it was my reporting at The Hartford Courant that catapulted this issue to the fore. 2. In the summer, I shadowed a nonprofit organization that is working with a local hospital to reduce excessive emergency room visits by people on Medicaid. Driving ER visits is the inability by Medicaid patients to find primary-care physicians who will take their insurance. After a number of patients were reluctant to talk, some opened up to talk about their health struggles. 3. In the late summer, as part of The Hartford Courant’s retrospective for its 250th anniversary, I wrote an article about the founding of Hartford Hospital. Archived materials informed my report, as did a long-retired physician and archivist who connected the dots between a major factory explosion in the 1800s and the founding of the hospital.
